Individual
JENNIFER S BRECHTEL
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PMHNP-BC
Contact information
Practice address
1600 BROAD AVE, GULFPORT, MS 39501-3603
(228) 863-1132
(228) 865-1700
Mailing address
1600 BROAD AVE, GULFPORT, MS 39501-3603
(228) 863-1132
(228) 865-1700
Taxonomy
Speciality
Code
Description
License number
State
104100000X
Social Worker
C6737
MS
106H00000X
Marriage & Family Therapist
C6737
MS
363LP0808X
Psychiatric/Mental Health Nurse Practitioner
Primary
R873301
MS
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
02309788
—
MS
Enumeration date
09/22/2006
Last updated
01/27/2010
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